I’ve had a Maryland bridge replacing my upper left premolar for more than 30 years. Faculty dentists at a local university originally made and placed it, and I never had a problem with it until about two years ago.
Since then, the bridge has come loose several times. My general dentist has reattached it, but each time the repair has only lasted a short while. The bridge itself still looks like it’s in excellent condition. My husband had two Maryland bridges placed around the same time, and his are still secure.
I would really like to keep my existing bridge rather than replace it if possible. How can I find a dentist with the experience to properly reattach it so it stays in place? – Thanks. Maggie from IN
Maggie,
Maryland Bridge
A Maryland bridge can last for many years when the teeth are prepared correctly, the bridge is properly designed, and the dentist follows proper bonding techniques. Your bridge stayed in place for more than 30 years, so the original tooth preparation and bridge design were clearly successful.
The problem appears to have started after the bridge came loose. Re-bonding a Maryland bridge requires more than simply applying new cement or bonding material.
What Does Proper Re-Bonding Involve?
For a traditional Maryland bridge with metal wings, the dentist needs to prepare the metal surfaces again before replacing the bridge. Proper surface preparation helps the new bonding material attach securely.
The process should include:
- Thoroughly cleaning the metal wings
- Re-etching the metal surfaces
- Applying a bonding agent designed for use with metal
- Using a resin designed for strong metal bonding, such as Panavia
How Can You Find a Dentist Familiar With This Technique?
We recommend looking for a dentist with substantial experience and continuing education in restorative and cosmetic dentistry. AACD accreditation may help because accredited cosmetic dentists generally have extensive knowledge of bonding materials and techniques.
Another credential worth considering is Fellowship in the Academy of General Dentistry. Dentists who earn this distinction have completed extensive postgraduate continuing education beyond basic licensing requirements.
Most importantly, ask whether the dentist is familiar with Panavia or another resin specifically for use with metal. A clear answer can help you find someone comfortable with the bonding technique your bridge requires.
Brian LeSage, DDS, an accredited fellow of cosmetic dentistry in Beverly Hills, sponsors this post. Read why his patients say he is the best cosmetic dentist in Beverly Hills.
